Iatrogenic Angiogenesis

Gupta, Kalpna

doi:10.1007/978-94-007-5678-6_5

Cited by 5 publications

(6 citation statements)

References 46 publications

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“…Opioids are used widely in cancer patients, but studies have suggested that some of them may promote cancer progression. The main mechanisms responsible for this effect are the stimulation of angiogenesis and immunosuppression, mainly mediated by agonism at MOR [66]. Studies have suggested that morphine has the greatest immunosuppressive potential, and fentanyl has intermediate potential, whereas buprenorphine and tramadol have shown the lowest or no immunosuppressive effect [67].…”

Section: Treatment Of Cancer-induced Bone Painmentioning

confidence: 99%

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Zajączkowska

Kocot-Kępska

Leppert

et al. 2019

IJMS

167

127

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The skeletal system is the third most common site for cancer metastases, surpassed only by the lungs and liver. Many tumors, especially those of the breast, prostate, lungs, and kidneys, have a strong predilection to metastasize to bone, which causes pain, hypercalcemia, pathological skeletal fractures, compression of the spinal cord or other nervous structures, decreased mobility, and increased mortality. Metastatic cancer-induced bone pain (CIBP) is a type of chronic pain with unique and complex pathophysiology characterized by nociceptive and neuropathic components. Its treatment should be multimodal (pharmacological and non-pharmacological), including causal anticancer and symptomatic analgesic treatment to improve quality of life (QoL). The aim of this paper is to discuss the mechanisms involved in the occurrence and persistence of cancer-associated bone pain and to review the treatment methods recommended by experts in clinical practice. The final part of the paper reviews experimental therapeutic methods that are currently being studied and that may improve the efficacy of bone pain treatment in cancer patients in the future.

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Section: Treatment Of Cancer-induced Bone Painmentioning

confidence: 99%

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Zajączkowska

Kocot-Kępska

Leppert

et al. 2019

IJMS

167

127

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“…Use of opioids is fraught with side effects including hyperalgesia, dependence, and tolerance, re-viewed by Gupta et al (37). Furthermore, opioids adversely influence RBC rheology by altering their membrane structure, increase mast cell degranulation-induced inflammation, and influence organ pathology via their coactivation of receptor tyrosine kinases leading to mitogenic signaling (35,37). Importantly, opioids do not treat the underlying mechanisms evoking pain, and considerable concerns regarding opioid use have led to opioid phobia, often leading to undertreatment of sickle cell pain (8).…”

Section: Mechanism-based Strategies To Target Sickle Cell Painmentioning

confidence: 99%

Targeting pain at its source in sickle cell disease

Gupta

Jahagirdar

Gupta

2018

American Journal of Physiology-Regulatory, Integrative and Comp

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Sickle cell disease (SCD) is a genetic disorder associated with hemolytic anemia, end-organ damage, reduced survival, and pain. One of the unique features of SCD is recurrent and unpredictable episodes of acute pain due to vasoocclusive crisis requiring hospitalization. Additionally, patients with SCD often develop chronic persistent pain. Currently, sickle cell pain is treated with opioids, an approach limited by adverse effects. Because pain can start at infancy and continue throughout life, preventing the genesis of pain may be relatively better than treating the pain once it has been evoked. Therefore, we provide insights into the cellular and molecular mechanisms of sickle cell pain that contribute to the activation of the somatosensory system in the peripheral and central nervous systems. These mechanisms include mast cell activation and neurogenic inflammation, peripheral nociceptor sensitization, maladaptation of spinal signals, central sensitization, and modulation of neural circuits in the brain. In this review, we describe potential preventive/therapeutic targets and their targeting with novel pharmacologic and/or integrative approaches to ameliorate sickle cell pain.

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“…Opioids, by activating MOP ( µ ) opioid receptors located on vascular endothelial cells, activate and promote angiogenesis and networking of new blood vessels, which play an important role in the transfer of cancer cells from the primary lesion site to the host cardiovascular system and further to the metastatic lesion sites. This mechanism involves, among other things, the vascular endothelial growth factor (VEGF) [ 33 , 45 ]. Studies by Lennon et al have confirmed that opioids stimulate the migration and proliferation of endothelial cells, including vascular endothelial cells via the vascular endothelial growth factor (VEGF) [ 46 ].…”

Section: How Can Surgery and Perioperative Opioids Contribute To Cmentioning

confidence: 99%

Perioperative Immunosuppression and Risk of Cancer Progression: The Impact of Opioids on Pain Management

Zajączkowska

Leppert

Mika

et al. 2018

Pain Research and Management

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Opioids comprise an important group of drugs used in cancer pain pharmacotherapy. In recent years, more and more studies have emerged indicating the potentially immunosuppressive effects of opioid analgesics and their serious consequences, including the risk of cancer progression. The identification of these risks has prompted a search for other effective, and most importantly, safer methods of perioperative analgesic management. Regional analgesia techniques, which allow for a significant reduction in opioid dosing and thus diminish the risk of immunosuppression associated with these drugs, seem to offer substantial hope in this respect. A number of studies available in the literature assess the effects of regional analgesia techniques on cancer progression; however, it is often difficult to interpret their results owing to several perioperative factors (such as surgical trauma, inadequate pain and stress relief, and hypothermia) which are also attributed immunosuppressive effects and tend to be implicated in increased risk of cancer progression. Further research is needed to verify the available data on both the potential adverse effects of opioids and the possible protective effects of regional analgesia techniques on cancer patients.

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Iatrogenic Angiogenesis

Cited by 5 publications

References 46 publications

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Targeting pain at its source in sickle cell disease

Perioperative Immunosuppression and Risk of Cancer Progression: The Impact of Opioids on Pain Management

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